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Alison Boden, MPH, Registered Dietitian

Alison received her undergraduate degree from UC Davis, followed by graduate training in nutrition and public health from the University of North Carolina at Chapel Hill.  As a practitioner of integrative nutrition she takes a holistic approach to wellness, recognizing that the foundation for optimal health and healing begins with a health promoting diet. Her emphasis is on using medical nutrition interventions to create a basis for health promotion and healing.

A lover of good food, Alison believes that a healthful diet should be thoughtful, enjoyable and satisfying.  Each meal does not only provide calories, but is an opportunity to supply our organs with the nutrients and building blocks needed for health. When the body is out of balance, as in the case of infertility, proper food choices can correct deficiencies and bring balance back to the system. What you eliminate from your diet is often as important as what you include. Consultations with Alison will help you address the key components of your diet that may be affecting your fertility and wellbeing, as well as help prepare your body for pregnancy.

Alison has experience assessing and counseling clients related to pregnancy and fertility, weight management, lipid control, food allergies, digestive health, sports nutrition, and chronic diseases such as cardiovascular, kidney disease and cancer. She views each person as a unique individual, and is dedicated to educating patients on natural ways to achieve optimal health and allowing them to take an active role in their health care decisions.

Alison is a member of the American Dietetic Association and the Women’s Health and Integrative and Functional Medicine practice groups.

My husband and I never thought having a family would be a struggle.  His siblings and my cousins were all VERY fertile… why shouldn’t we be the same?  Little did we know, as we said our “I Do’s”, that a condition called endometriosis was wreaking havoc on my reproductive organs.

Such was its devastation, that our 1^st pregnancy was an ectopic, resulting in the rupture of one of my fallopian tubes.  Had we not gotten to surgery in time I could have died.  My husband still reels from the memory of me handing him my wedding ring as they wheeled me into surgery. 

My doctor at the time didn’t see my other symptoms, (missed menses, constipation, heavy menses) and the ectopic as a problem.  The solution therefore was to put me on Clomid.  After a year of trying, a family member recommended finding a new doctor. 

My new doctor stated that my symptoms were consistent with endometriosis but could not be certain without “going in” to make sure.  Thus began the 1^st of 8 laparoscopies (over 6 years) to “clean me up”.  I had 2 surgeries in one month. My endometriosis was so bad that I had organs being pulled together.  After the 1^st surgery my doctor had me begin the Clomid regimen. After 4 cycles of treatment she said that I would need IVF to get pregnant.  Here is where the true shock began.   

My husband and I live modest lives… I’m a Kindergarten teacher and he works in construction.  Although we lived comfortably, the cost of IVF seemed unattainable.  We discussed our options.  IVF meant no more vacations, no more upgrades to our home, and no more “let’s buy it” spending.  It also meant facing the dark reality that we may never have children.  After getting our finances in order we visited the Pacific Fertility Center in San Francisco, which our doctor had recommended.  It was a good visit and was our first step.  We made our plans to undergo IVF that summer, when I would be off from school. 

When the medications arrived we were in awe at the number of needles we had.  We were ready to begin this process… I had but one condition… since I was the receiving the injections, my husband had to give them.  I felt it only fair and would enable him to be very involved in the whole process.  He cried before giving me the first shot in my stomach.  He said he didn’t want to hurt me.  So I cupped his head in my hands and said, “If we want to have a baby, you have to give me the shot”.  He did.  I really didn’t have that many side effects.  What was more bothersome was the bruising and pain at the injection sites.  Of course as blood work and ultrasounds were done along the way, more meds were needed, bye- bye money.  Unfortunately, round 1 was unsuccessful and we discovered that I was not a top egg producer.  Of course my hubby had no problems with his soldiers… it was all me.  Ugh!  I think we had some extra embryos and did a frozen cycle right after… but to no avail.  Since we were committed to not only sticking to IVF but, also only doing it during the summers we had time not only to regroup, but save money.  Sadly, round 2 was also a dud.

For round 3 we had 3 embryos implanted.  And on 7-7-07 we discovered I was pregnant.  My husband said the date was a sign of good luck.  We were so happy and relieved.  We were finally going to expand our family.  Each month went by with no problems.  We had some stress… my work life was getting chaotic and my father was being a difficult patient recovering after heart surgery.  But my pregnancy was flawless.  On week 20 we discovered we were having a boy and by the end of the evening we had named him Lucius. 

However, one week later, while talking with some parents at school about the Halloween Parade guidelines, my water broke.  Even now I weep remembering that very moment.  The hospital sent me home to wait it out, hoping the hole would close.  However, by the third day I developed a fever and was going septic.  I had to deliver my little boy.  I begged with the doctor for a way to save my baby.  She said the waiting 4 more weeks until his lungs might be mature enough for survival was not possible since now I was also in danger.  There I was in the maternity ward waiting to deliver a dead baby. 

All I could think of was that I had failed my husband again.  In the months that followed I wished I had died with my baby.  I felt it was the only way I would feel less of a failure and the pain from my loss would be gone.  My husband would hold me and remind me that if he’d lost both of us he would be all alone.  I even offered to let him divorce me so he could find a wife that would be able to give him children.  I don’t think I’ve ever seen him as angry as when I said that.  He was willing to keep trying if I was.  And he felt that if we couldn’t have a child, then that’s just the way it would be.

So along came rounds 4 and 5, both of which failed.  The strain of infertility on our marriage was slight… but was there.  We were lucky to be able to talk it out.  What was difficult was the loss of Lucius.  There was pain there that lingered in each of us in different ways.  My husband started drinking more than usual and I found myself very resentful of others that had children/babies.  Amazingly, we made it through, pulling each other out of it.

When round 6 came along, with all we had been through, neither of us really expected it to succeed.  But amazingly we struck gold and were on our way to a family again.  However, this time we were on pins and needles.  I honestly don’t think I would have mentally survived another loss.  So we took every precaution possible, my mom even went to work with me 2-3 days a week to help out.  After the first trimester I decided that to be afraid was unfair to my unborn child.  Therefore, we started planning for this baby.  Registering and decorating.  Once we discovered we were having a girl… OMG!  Our joy could not be contained.  Every doctor visit that pronounced us healthy was fantastic.

Other than gestational diabetes, everything was great. Our little Lyra was born March 13, 2011 weighing 7lbs. 8 oz. and 20.5 in. long.  She was perfect!  We were perfect!

So after 10 years of trying, 6 years being IVF, 3 acupuncturists, body talk therapy, an ectopic pregnancy, and our Angel Baby Lucius, our family is now complete.  When I gaze into Lyra’s eyes and see her in awe of me I know she was worth all the sacrifices and tears.    

- Martina & Leandro

A statistic that we follow closely at PFC is our cumulative pregnancy rate in a given year.  This is defined as a patient’s chance of taking home a baby after one IVF cycle, but it includes the fresh embryo transfer and any frozen embryo transfers resulting from that one cycle.  These rates are shown in the table and are broken down into maternal age groups.  The numbers are calculated by looking at how many patients delivered a baby from their fresh transfer (43% of patients under age 35) and then adding in pregnancies achieved from the frozen embryos for patients that did not get pregnant in the fresh cycle (totals 64% of patients in this group).  So in this age group, 2 out of every 3 patients had a baby from just one IVF cycle.  Similarly, for patients doing a single cycle with donor oocytes, 74% had a baby.

Cumulative pregnancy rates have special importance since PFC is a national leader in reducing the number of embryos transferred at one time while still maintaining exceptionally high overall pregnancy rates.  One healthy baby at a time is the goal of fertility treatment at PFC and for every patient, a singleton pregnancy is the safest and most likely way to have a healthy baby.  At PFC we work carefully with every patient to reduce their exposure to a multiple pregnancy and all its risks for mother and baby.  And a big part of our strategy involves freezing embryos successfully so that we can use embryos conservatively and efficiently to generate more singleton pregnancies, and fewer multiples. Multiple pregnancies are a complication of IVF treatment, and we strive to avoid them. 

Patients with the highest risk for multiple pregnancy are those where maternal age is <35, doing their 1^st or 2^nd IVF cycle or those patients using donor eggs.  We encourage these individuals to transfer just a single embryo during their IVF cycle and to freeze their surplus embryos for use later.  The frozen embryo program has been so successful here at PFC that it provides very high pregnancy rates for those patients that need to use their embryos from the freezer.  It also means that we don’t have to risk transferring many embryos in the fresh IVF cycle because we have the frozen embryos as a back-up. And most patients that are doing elective single embryo transfer qualify for one of PFC’s financial plans (e.g. the refund plan) that include the cost of frozen embryo transfer cycles in the original price.

We believe that using embryos conservatively is the safest treatment.  And we don’t see big differences in pregnancy rates between patients that transferred just one embryo vs. those that transferred 2.  In fact, patients that received donor eggs and transferred 1 or 2 embryos had the same delivery rates, but those transferring 2 had a 35% twin rate.  In our efforts to reduce this twin rate, we are now transferring 1 embryo 60% of the time in the donor egg program, and 40% of the time in patients aged less than 35.

We want our patients to have healthy babies and we are working to make this possible while still maintaining high success rates.  Our goal is one healthy baby at a time.

 - Joe Conaghan, Ph.D., HCLD & Embryologist Erin Fischer

Tune in and watch PFC’s Dr. Liyun Li on KTVU Channel 2 News tonight at 10p.m!  She will be talking about fertility treatment and twin births.  Don’t miss it!